Mutilating hand injuries in children are injuries that are significant not only because of the actual injury caused to tissue but also owing to the significant psychological impact they have on the patient and family alike. Management of these injuries requires significant surgical skill as well as a well-planned and well-executed treatment protocol. This article discusses the etiology, incidence as well as treatment of mutilating hand injuries in a child. Relevant literature has been reviewed and appropriate treatment guidelines have been provided.